Heart disease does not only occur in adults and the elderly, newborn babies and kids can also develop cardiac disease. Some congenital heart defects in children are simple and treatments are not necessarily required. Other congenital heart defects in children seem to be more complex and may require several surgeries performed over a period of several years. Serious congenital heart defects are often diagnosed before or soon after the child is born. If any signs and symptoms are noticed, parents must seek immediate medical attention in order to get accurate and timely diagnosis, leading to effective treatment plans.
The causes of pediatric heart disease can be divided into 2 main categories:
- Congenital heart defects in children
During the first six weeks of pregnancy, the heart of the fetus begins taking shape and starts beating. The major blood vessels that reach to and run from the heart also begin to develop during this critical time of the gestation. At this point, the heart defects may begin to develop. Contributing factors might include genetics, certain medical conditions, some medications and environmental factors such as smoking. The statistical data reveals that the average incidence rate of congenital heart defects reported in different studies is up to 8 per 1000 live births. Serious congenital heart defects are often diagnosed before or soon after the baby is born. In some cases, heart defects are discovered during adulthood such as abnormal blood vessels, septal defects defined as holes in the heart that form in the walls between heart chambers and other complex heart conditions. If heart defects are left untreated and found in adult patients when the diseases progress severely, surgical treatment might not be an option. Nonetheless, certain congenital heart diseases are non-serious conditions e.g. small holes of septal defect and mild heart valve stenosis which occurs when the heart’s valve narrows. In such non-serious conditions, medical treatments are not necessarily required. However, lifestyle modifications to prevent other complications are crucially recommended.
- The acquired heart diseases in children
Pediatric acquired heart disease develops after birth. The common acquired heart diseases in children include:
- Rheumatic heart disease: Rheumatic heart disease is a condition in which the heart valves have been permanently damaged by rheumatic fever. The heart valve damage may start shortly after untreated or under-treated streptococcal infection. An immune response causes an inflammatory condition, resulting in continuous valve damages. Rheumatic fever most often affects children of school age. Although streptococcal infection is common, rheumatic fever seems to be rare due to the advancements of medicines, especially in developed countries.
- Kawasaki disease: Kawasaki disease is a leading cause of acquired heart disease in children. It causes inflammation in the walls of arteries throughout the body and the inflammation tends to damage the coronary arteries which supply blood to the heart muscle, causing coronary artery aneurysm.
- The inflammation of heart’s muscles, known as viral myocarditis caused by all forms of viral infection can potentially cause inflammation of heart’s muscles and disrupting of the electrical pathways that signal the heart to beat properly. As a result, it is one of major causes of sudden cardiac arrest.
- Heart rhythm problems.It refers to abnormal heart beats including heart beats too quickly, too slowly, or with an irregular pattern. The most common heart rhythm condition found in children is called tachycardia when heart beats too fast and it cannot fill with blood before it contracts. Related symptoms e.g. heart palpitations, rapid heartbeats, chest pain and dizziness might come and go randomly. However, it can lead to fatal conditions such as sudden cardiac death.
Signs and symptoms of congenital heart disease
Serious congenital heart disease usually becomes clearly evident soon after birth. Signs and symptoms include:
- Shortness of breath during feedings, leading to impaired development
- Pale gray, purple or blue skin color and fingernails (cyanosis)
- Rapid breathing
However, child may not have any noticeable signs of a problem until reaching the age of 20-30. Symptoms that might indicate heart disease may involve shortness of breath during exercise and easily tiring or fainting during activity.
Treatment of congenital heart disease
Certain congenital heart defects, such as small holes, may correct themselves as the child grows. However, some heart defects are serious and treatment is highly required. Depending on the type and severity of heart defect, congenital heart defects can be treated with:
Procedures using catheterization
Some children and adults might have their congenital heart defects repaired using catheterization techniques. This less invasive procedure allows the repair to be done without surgically opening the chest and heart. Catheter procedures can often be used to fix holes or areas of narrowing. During performing procedures, a thin tube (catheter) is inserted into a leg vein and guides it to the heart with the assistance of X-ray images. Once the catheter is positioned at the site of the defect, tiny tools such as a mesh patch or plug is threaded through the catheter to close the hole or to repair the defects. The heart tissue grows around the mesh, permanently sealing the hole within 3 months.
This procedure can be performed in children aged over 5 and adults. However, antiplatelet drug, aspirin will be prescribed for at least 6 months in order to provide platelet anti-aggregation effect and prevent thrombus formation in the treated areas. After receiving treatment, close follow-ups with echocardiogram are required as scheduled, every 1, 3, 6 months and 1 year. More importantly, all medical advices given by cardiologists must be strictly followed.
Although catheterization can be used to treat congenital heart defects up to 75%, this procedure might not be suitable for some complicated conditions. These conditions may require heart surgery as a first-line treatment. Selected treatment option is primarily determined by size, location and type of the defects as well as individual’s conditions.